In the past decade, complementary and alternative medicine (CAM) has been widely used by patients to help manage a variety of health problems. Diabetes mellitus (DM) is a chronic condition that affects over 20,000,000 Americans. Conventional allopathic approaches to DM care are often ineffective and although it is anecdotally certain that a large number of adults with DM use CAM, the prevalence, patterns, and creditors of CAM use, as well as the effectiveness of various CAM therapies used by patients with DM, is not well understood. There are, however, several reasons to postulate that mind-body based complementary therapies may offer safe, practical and cost-effective methods to help many people better manage diabetes. In this Career Development Award (K23), Dr. Robin Whitebird will focus on the application of mind-body and related CAM therapies in the care of adults with DM and related chronic diseases. Dr. Whitebird will develop a detailed conceptual model that demonstrates the potential impact of mind-body therapies on basic pathophysiologic pathways that influence both glucose levels and blood pressure in adults with type 2 DM. To facilitate this, Dr. Whitebird will obtain detailed input from her mentors and others with relevant expertise and work to expand her own skills in CAM-relevant research methodologies, including completing formal coursework in clinical research methods and complementary and alternative medicine. Dr. Whitebird's overall goal is to become an independent investigator conducting clinical research of mindbody approaches as adjunct therapy in patient management of DM and related chronic diseases. Dr. Whitebird will conduct a series of integrated research studies at the Health Partners Research Foundation to examine the use of CAM by patients with DM and evaluate the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) intervention on patient self-care behaviors and metabolic outcomes (including control of glucose and blood pressure) in adults with type 2 DM. Study 1 consists of qualitative in-depth interviews (N=50) to explore why and how people with DM use CAM therapies, mind-body techniques in particular for DM and other health purposes. Data from Study 1 will inform development for Study 2, a randomized controlled pilot study (N=60) designed to provide data, including feasibility and preliminary outcomes, for a larger R01 submission on the use of MBSR as adjunct treatment in patient management of DM. This proposal focuses on the use of a mindfulness-based stress reduction intervention with patients with diabetes to determine whether there is a positive impact on the patient's ability to maintain good health. [unreadable] [unreadable] [unreadable]